Introduction of the National Meningococcal C Vaccination Program.

In January 2003, the Commonwealth G o v e rnment commenced the National Meningococcal C Vaccination Program. This p rogram provides free meningococcal C conjugate vaccine over the next four years to all children and adolescents who turn one to 19 years of age in 2003, a target group of almost 6 million. The meningococcal C vaccine has also been added to the Australian Standard Vaccination Schedule at 12 months of age. A rise in the incidence of meningococcal disease in Australia, an increasing mortality rate due to the C strain of the disease and success in England and Wales with meningococcal C vaccination, have contributed to the decision by the Australian Government to implement this program. The meningococcal C vaccine is a new conjugate vaccine, more effective and immunogenic than the polysaccharide vaccine p reviously available. The polysaccharide vaccine has been available for a number of years. However, it provides protection only for a limited time against serogroups A, C, W135 and Y, and is not effective in infants under two years of age. The new conjugate vaccine (conjugation involves attaching a carrier protein to the oligosaccharide antigen formed from the coat of the bacteria 1) was approved for use in Australia in 2001. It induces a T-cell dependent antibody response and immunological memory, and is immunogenic in children under two years of age. It is expected that immunity induced by the conjugate vaccine will be long term. Notifications of meningococcal disease in Australia to the National Notifiable Diseases S u rveillance System (NNDSS) have been gradually increasing since 1991 (337 cases) to 677 cases in 2002. 2 Meningococcal disease is caused by invasive infection with N e i s s e r i a m e n i n g i t i d i s, resulting in meningitis and/or septicaemia. While meningococcal disease may affect all age groups, there is a bimodal age distribution with the highest incidence rates in c h i l d ren under five years of age and adolescents and young adults. 3 Approximately 32 per cent of cases in Australia are sero g roup C (the proportion of serogroup C isolates has been rising since 1995) and the majority of the remaining cases are sero g roup B. 4 Unfortunately, no effective vaccine is currently available for serogroup B disease. A similar vaccination program was launched in England and Wales in November …